Endocrine Fatigue: Discover the Role of Your Thyroid, Adrenals, Low Blood Sugar, and More.

By Sidika E. Karakas MD

You feel fatigued. Your thyroid tests seem to be out of range. Why does your doctor say they are normal? Why does your doctor refuse to prescribe certain medicines or order certain tests? Why do you still feel fatigued after taking bunch off supplements? Why do you get tired and sleepy and crave for sweets in the afternoons? If you like to know the answers, you want to read this book.
In a typical endocrine practice at least one third of the patients complain of tiredness or fatigue. Unfortunately doctors don't always spend enough time to evaluate these complaints in detail because of the relatively short time allowed for medical appointments. I wrote this book to make up for these missed opportunities, and provide unbiased, useful and practical information for our patients. In this book I will share my knowledge and experience and most recent medical developments as clearly as I can.
To make the best use of your time, I organized a good portion of the book in question-and answer format. These are the questions I get from my patients all the time and therefore I suspect you have them too. I included figures to make my explanations clear and simple. In addition, I summarized the most important and useful information at the end of each section. You may want to first look at these summaries, and then read the parts which interest you in detail.
I believe that after reading this book you will understand how your endocrine glands and hormones work. You will decipher your test results. You will feel comfortable about discussing treatment options with your doctor. You will also make lifestyle choices that can improve your energy and stamina.
However, this book does not intend to provide medical advice. You need to work with your doctor for a treatment that takes into account your full health profile. My goal is to help you to gain knowledge and control, feel stronger and more energetic, and live your best life.

• Language: English
• Publisher: BookBaby
• Release date: Nov 18, 2022
• ISBN: 9781667875088

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© 2022 Sidika E. Karakas

ISBN: 978-1-66-787508-8

All rights reserved. This book or any portion thereof may not be reproduced or used in any manner whatsoever without the express written permission of the publisher except for the use of brief quotations in a book review.

If death is like a restful sleep, I will take it!

My sentiments during my internship at the Cook County Hospital, Chicago, Il.

Introduction

Would you like to know why your doctor says your thyroid is normal when your tests seem to be out of range? Why does your doctor refuse to prescribe certain medicines or order certain tests?  Why do you still feel fatigued after taking bunch off supplements? Why do you get tired and sleepy and crave for sweets in the afternoons? If you like to know the answers, you want to read this book.

I practiced endocrinology for a long time. I am an Emeritus Professor. I served as the chief of the Division of Endocrinology for twelve years at the University of California, Davis, Department of Internal Medicine. I have received numerous awards for both Clinical Excellence and Research Career Excellence. I have as much knowledge and experience as you can expect from an expert endocrinologist to explain the roles of endocrine glands and hormones in fatigue. This does not mean that I have all the answers. But I promise that I will give you solid information based on recent medical knowledge and evidence. I believe in continuing education. Each year the Endocrine Society organizes a symposium presenting the most recent developments in our field. I attended the latest symposium in June 2022 and included the relevant information from this meeting here as well.

I know about being tired, very tired, deadly tired, and exhausted. During my training as a resident at the Cook County Hospital of Chicago in 1970s, I spent many sleepless nights to come back from work, pick up my baby daughter from day care, and stay up late to study for board exams. Later, as an endocrinologist I took care of many women and men struggling through the same kind of fatigue and exhaustion. I believe I have some answers and I can help.

In my endocrine practice, at least one third of my patients complain of tiredness or fatigue. I find that detailed personal and family history and a careful physical examination are the basis for solid clinical judgement and logical laboratory investigation. Otherwise, ordering a bunch of tests as a fishing expedition is not helpful, and even may be harmful. In my opinion, eliminating wrong diagnoses is as important as making the right diagnosis. This is the first step.

The next step is choosing the proper treatment. This is very personal. There can be more than one right treatment. A treatment which is perfect for one patient may not be right one for another. My mentor Dr. Alice Bessman would urge us to listen to our patients, to remind us that our patients have a right to participate in their managements and to curb our arrogance.

I was frustrated in my practice with the short amount of time allowed for medical appointments. Typical initial consultations were scheduled for 40 minutes and follow-up appointments for 20 or 25 minutes. This included the time for nurses to take the patients into exam rooms, take vital signs, update medications and record pharmacy information. This left 10 to 15 minutes for me to take my patient’s medical history, do the physical exam, order the appropriate laboratory tests and imaging studies, and prescribe medicines. I hardly had the opportunity to ask my patients what was going on in their lives. I know that this is true for primary care doctors as well. So, it is no wonder that when patients feel tired, fatigued, and exhausted, they seek information from Internet.  I am in favor of self-education and Internet is a valuable resource. However, I believe some Internet sites provide biased information just to sell tests and supplements. I have many patients who have felt even more helpless, anxious, and frustrated after trying those.

In this book I will share my experience and most recent medical knowledge as clearly as I can. When I look back, I regret my younger years spent feeling tired, fatigued, and frustrated. I want to help you to gain knowledge and control, feel stronger and more energetic, and live your best life.

I sincerely hope and believe that after reading this book you will understand how your endocrine glands and hormones work. You will decipher your test results. You will feel comfortable about discussing treatment options with your doctor. You will also make lifestyle choices that can improve your energy and stamina.  Please note, this book should not be taken as medical advice. Please work with your endocrinologist for a treatment that takes into account your full health profile.

I know you are busy. To get the most out of this book in the shortest amount of time, you may want to first look at the summaries at the end of each section, and then read in detail the parts which interest you. I have used a question-and-answer format to address specific questions you may have throughout your treatment.

You have my most sincere wishes for your good health and happiness.

Acknowledgements

The book you will be reading is much improved version of what I wrote originally, and I would like to thank my daughter Yasemin. I am the luckiest and the most grateful of mothers for having her as my daughter.

I am also very thankful to another hard working, smart, talented woman, Professor Wendy Buchan, PhD., for collaborating with me in several research projects over the years and sharing her menus and recipes for this book.

I am grateful to Dr. Alice Bessman who mentored me during my first faculty position and guided me in many ways. Later, she contributed to my research through the ALSAM foundation.

Finally, I owe my experience and insight to my patients, research participants, colleagues, and trainees.  I am grateful to all.

Table of Contents

Introduction

Acknowledgements

Chapter 1 - The Big Picture

Language of Hormones

The body has a thermostat that regulates hormones: Feedback regulation.

Only the free hormones have biological effects. Hormones bound to proteins don’t.

There is a difference between hormone replacement vs. hormone suppression treatments.

Common factors you may not think of can affect hormone levels and laboratory test results.

Antibodies against our own glands (autoimmunity) can cause hormone problems.

Summary: Language of Hormones

Chapter 2 - Thyroid and Fatigue

Overview of Thyroid Function and Fatigue Relationship

Summary: Overview